Discount Ticket Form Please provide the following information for one specific contact person. *Information is requiredContact InformationName* First Last Phone*Email* Contact's Email Confirm Email Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Please list the top three dates and entry times you would like to visit CuriOdyssey, along with the number of adult, child, senior and/or student tickets you would like to purchase. We will do our best to reserve tickets for your first choice of date and time.* What type of discount do you qualify for?* AZA/ASTC partner institution Museums For All (WIC, SNAP, etc.) Teacher Military Discover & Go Membership DetailsInformation about your membership at reciprocal museum or zoo.Name of museum or zoo*You must have a current membership.Location of museum or zoo*Membership Expiration Date* Date Format: MM slash DD slash YYYY Museums For AllName of Benefit Program*WIC, SNAP, Golden State Advantage/ EBT, Medicaid, MediCal, Healthy Families, Kaiser Cares For KidsName of Cardholder* First Last Teacher InformationName of School*Enter name of school where you currently teach.Military InformationName of Military Cardholder* First Last Branch of the Military*Current Status*For example: retired, veteran, active, reserve.Discover & Go InformationName on Pass* First Last Name of Library*DocumentationUpload card or pass info.*For example: photos of front and back of your membership card, teacher ID. Maximum file size: 8MB Drop files here or Accepted file types: jpg, gif, png, pdf.